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Ileal conduit versus single stoma uretero-cutanoustomy after radical cystectomy in patients ≥ 75 years; which technique is better? a prospective randomized comparative study

  • Urology - Original Paper
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Abstract

Purpose

To compare the clinical results and patients’ health-related quality of life (HR-QoL) of ileal conduit (IC) versus single stoma uretero-cutanoustomy (SSUC) after radical cystectomy in two groups of randomly selected patients ≥ 75 years.

Methods

From January 2013 to March 2018, 100 patients ≥ 75 years with muscle invasive BCa underwent RCX and cutaneous diversion. Patients were divided in two groups; group I underwent IC (50 patients) and group II underwent SSUC (50 patients). Postoperative evaluation included clinical, laboratory, radiographic and HR-QoL. The latter was performed using the Functional Assessment of Cancer Therapy–Bladder Cancer (FACT-BL) after 12 months postoperatively.

Results

Patients’ characteristics were comparable between both groups. No intraoperative complications occurred. Early postoperative complications occurred in 27 patients [16 (35.5%) in group I and 11 (23.9%) in group II (p = 0.02)]. Delayed postoperative complications occurred in 26 patients [6 (13.3%) in group I and 20 (43.4%) in group II, (P = 0.002)]. No significant differences between both groups regarding the physical, social/family, emotional, functional and additional concerns scales of FACT-BL questionnaire were reported.

Conclusion

SSUC is a good alternative to IC in elderly frail patients  ≥ 75 years and those with multiple comorbidities who require rapid surgery in terms of perioperative complications and HR-QoL. However, the stomal complications and the possibility of a frequent stent exchange are considered its drawbacks.

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Data availability

No data was used for the research described in the article.

Abbreviations

RCX:

Radical cystectomy

BCa:

Bladder cancer

UD:

Urinary diversion

IC:

Ileal conduit

SSUC:

Single stoma uretero-cutanoustomy

NB:

Neobladder

UUT:

Upper urinary tract

HR-QoL:

Health related quality of life

CVS:

Cerebro-vascular stroke

TCC:

Transitional cell carcinoma

SCC:

Squamous cell carcinoma

ERAS:

Enhanced recovery after surgery

CU:

Cutaneous ureterostomy

MCU:

Modified cutaneous ureterostomy

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Funding

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Authors and Affiliations

  1. Urology and Nephrology Hospital, Assiut University, Assiut, 71515, Egypt

    Ahmed M. Moeen, Mohammad A. Faragallah, Mohamed A. Zarzour, Ahmed A. Elbehairy & Hosny M. Behnsawy

Authors
  1. Ahmed M. Moeen
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  2. Mohammad A. Faragallah
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  3. Mohamed A. Zarzour
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  4. Ahmed A. Elbehairy
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  5. Hosny M. Behnsawy
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Contributions

AMM; study concept and design, manuscript preparation and review, HMB; data acquisition and statistical analysis, MAF; manuscript editing, A A. E; data acquisition, MAZ; data analysis and interpretation.

Corresponding author

Correspondence to Ahmed M. Moeen.

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Conflict of interest

All authors declare that they have no conflicts of interest.

Informed consent

Informed consent for publication was obtained from the patients.

Registry and registration number of the study

N/A. - Ethical IRB number: 17300929

Animal studies

N/A.

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Moeen, A.M., Faragallah, M.A., Zarzour, M.A. et al. Ileal conduit versus single stoma uretero-cutanoustomy after radical cystectomy in patients ≥ 75 years; which technique is better? a prospective randomized comparative study. Int Urol Nephrol 55, 1719–1726 (2023). https://doi.org/10.1007/s11255-023-03609-x

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  • DOI: https://doi.org/10.1007/s11255-023-03609-x

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